Active NPI
Charles L Clifton Jr., M.D.
- Anesthesiology Physician
- Decatur, GA
National Provider Identifier
1194764795
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 029608
- Practice address
- 2701 N Decatur Rd
Decatur, GA 30033-5918 - Phone
- (678) 514-1991
- Fax
- (678) 514-1992
- NPI assigned
- Jun 6, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 029608 | GA | Primary |
Addresses
Primary practice location
2701 N Decatur Rd
Decatur, GA 30033-5918
Mailing address
PO Box 551420
Fort Lauderdale, FL 33355-1420
Phone (800) 243-3839
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000423431A | Medicaid | GA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dekalb Anesthesia Associates, P a | Anesthesiology | Past | Accepting new patients |
| Dekalb Pain Center | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Anesthesiology Physician
- Decatur, GA
- NPI 1528004538
-
- Pain Medicine Physician
- Decatur, GA
- NPI 1407892417
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149552000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1361318400000",
"number": "1194764795",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 551420",
"city": "FORT LAUDERDALE",
"state": "FL",
"postal_code": "333551420",
"telephone_number": "800-243-3839",
"fax_number": "954-839-2569"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2701 N DECATUR RD",
"city": "DECATUR",
"state": "GA",
"postal_code": "300335918",
"telephone_number": "678-514-1991",
"fax_number": "678-514-1992"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLIFTON",
"first_name": "CHARLES",
"middle_name": "L",
"name_suffix": "Jr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-06",
"last_updated": "2013-02-20",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "GA",
"license": "029608",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000423431A",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Decatur, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.